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Module 103: Theme 3: Physiology of the cardiovascular system. Principles of pathology, diagnosis and treatment of cardiovascular disease > Introducing how the cardiovascular system fails > Flashcards

Introducing how the cardiovascular system fails Flashcards

(73 cards)

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1
Q

What is a stroke?

A

Rapid loss of brain function due to loss of perfusion to parts of the brain

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2
Q

Give another name for a stroke

A

Cerebrovascular accident

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3
Q

List the two types of stroke

A

Ischemic

Haemorrhagic

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4
Q

Define an ischemic stroke

A

Cerebral blood vessels become blocked

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5
Q

Define haemorrhagic stroke

A

Cerebral blood vessels rupture

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6
Q

List some stresses which may cause a blood vessel to burst

A

High blood pressure
High wall tension/Large diameter
Low elasticity
Turbulent flow

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7
Q

List some damages which may cause blood vessels to burst

A

Diabetes
Trauma eg. PCI
Atherosclerosis

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8
Q

Define aneurysm

A

A pathological, localized, blood-filled balloon-like bulge in the wall of a blood vessel

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9
Q

Define ruptured aneurysm

A

When the aneurysm bursts and blood leaks out

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10
Q

What is tension in a cylinder?

A

The force tangential to the circumference of the cross section that is trying to rip the wall apart

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11
Q

What is the wall tension like in a larger vessel?

A

Greater

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12
Q

Give the equation for wall tension in a cylinder

A

Wall tension = pressure x radius

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13
Q

What is compliance?

A

The change in volume caused by a change in pressure

Stretchiness

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14
Q

What happens if there is low compliance

A

A change in pressure results in a very little change in volume

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15
Q

What reduces arterial blood pressure?

A

Age
Disease
Build up of connective tissue
Atherosclerosis

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16
Q

Do veins or arteries have more compliance?

A

Veins

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17
Q

Describe the two characteristics of laminar flow

A

All molecules travel in the same direction

Slower speed at the edges

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18
Q

Describe the causes of turbulent flow

A

When the low viscosity molecules flow at high speeds in random directions passing junctions and mixing

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19
Q

List the activities of the endothelium

A 
Angiogenesis
Haemostasis 
White cell recruitment
Hormone trafficking 
Blood vessel tone
Fluid filtration
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20
Q

Describe the symptoms of acute myocardial infarction

A

Extremely painful chest pain
However some women present atypically where there is an absence of chest pain but they experience jaw, back, neck or head pain followed by symptoms of nausea, cough, dyspnoea or weakness

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21
Q

When can an AMI become fatal?

A

When it leads to arrhythmia or heart failure after many AMIs

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22
Q

What does an AMI cause?

A

Reduced capacity of the heart to pump

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23
Q

Give the symptoms of atherosclerosis

A

Asymptomatic however causes other diseases which possess symptoms

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24
Q

List the main causes of atherosclerosis

A

Immune action
Hyperlipidemia
Unknown aetiology

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25
What is coronary artery disease?
Narrowing/obstruction of the arteries supplying the heart
26
Give the 2 causes of CAD
Atherosclerosis | Coronary vasospasm
27
What is a plaque rupture?
When a fibrous plaque bursts open
28
How safe are atheromas?
Quite safe even if they occlude 50% of the vessel.
29
What happens if a plaque rupture occurs in a coronary artery, thrombus or embolism?
A myocardial infarction occurs
30
Describe the ways the sympathetic nervous system responds to an MI
Release of noradrenaline and adrenaline in response to haemodynamic abnormalities and pain
31
Describe the ways the sympathetic nervous system responds to heart failure
Increase heart rate Increase contractility Increase peripheral resistance Increased risk of arrhythmia
32
Give the equation for net pressure
Net pressure = hydrostatic pressure + osmotic pressure
33
What is pulmonary oedema and explain its cause?
Fluid accumulation in the lungs caused by left heart failure. Damming of the blood leads to increase in hydrostatic pressure in pulmonary circulation
34
List the symptoms of pulmonary oedema
Dyspnoea Orthopnoea Hypoxia
35
What is ascites?
The accumulation of fluids in the peritoneal canal
36
What is the main cause of ascites?
Heart failure
37
What is peripheral oedema?
The swelling of tissues especially in the ankles
38
State the main cause of peripheral oedema
Chronic low output heart failure
39
What is compensation?
Maintaining homeostasis of a physiological function despite stressors/malfunctions. Happens via endogenous physiological feedback using starling's law
40
What is decompensation?
A medical emergency where the heart fails to maintain adequate circulation after long standing previously compensated vascular disease
41
Describe cardiac remodelling
The growth of cardiac muscle leading to changes in shape, size and function caused by injury such as MI, hypertension or valve disease. The result is hypertrophy or dilation. May become pathological
42
Name the treatments that inhibit cardiac remodelling
ACE inhibitors | Spironolactone
43
Name the two types of ventricular hypertrophy
Eccentric | Concentric
44
Describe eccentric ventricular hypertrophy
Dilation due to volume overload
45
Describe concentric ventricular hypertrophy
Thicken due to pressure overload
46
What does ADH do?
``` Decreases diuresis (loss of water as urine) Causes kidneys to reabsorb more water ```
47
Where is ADH released from?
Posterior pituitary gland
48
What does aldosterone do?
Increases the reabsorption of NaCl in the kidneys thus decreases diuresis
49
Where is aldosterone released from?
The adrenal cortex
50
What effect does decreased diuresis have on blood pressure?
Increases blood pressure
51
What do diuretic drugs do?
Antagonise the hormones ADH and aldosterone leading to fluid loss and an increase in blood pressure
52
What does angiotensin 2 do?
Increases blood pressure by stimulating the release of ADH and Aldosterone, causes vasoconstriction and hypertrophy and cardiac remodelling
53
Describe the sequence of the renin-angiotensin- aldosterone system
Angiotensinogen- renin enzyme- angiotensin I- ACE enzyme- Angiotensin II- aldosterone
54
What do thiazide and thiazide like diuretics do?
Block reabsorption at the DCT
55
Give an example of a thiazide and thiazide like diuretic
Indapamide
56
What do loop diuretics do?
Block reabsorption at the loop of henle
57
Give an example of a loop diuretic
Furosemide
58
What do K+sparing diuretics do?
Inhibit aldosterone receptors at the cortical collecting duct
59
Give an example of a K+ sparing diuretic
Spironolactone
60
Define heart failure
The cardiac output does not meet the needs of the lungs and body
61
Describe chronic low output heart failure
There is a low cardiac output usually due to accumulated heart damage Chronic condition with poor 5 year survival rate
62
Describe decompensated heart failure and how the body responds.
Medical emergency which can lead to death if not treated. Kidney increases plasma volume to compensate for poor perfusion and leads to fluid overload. The heart is unable to pump the extra fluid so fluid damming leads to increased venous hydrostatic pressures. Increased back pressure further damages the heart. Capillaries become leaky and gas exchange can not occur
63
What symptoms are present in left heart failure and why?
Respiratory symptoms Right heart pumps into lungs but left atrium is too full therefore there is an increased hydrostatic pressure in pulmonary circulation
64
Describe congestive heart failure
The pulmonary vasculature becomes congested and in extreme cases the lungs fill with fluid from blood vessels
65
Describe right heart failure
This causes systemic symptoms. Increase in central venous pressure causes peripheral oedema and ascites
66
How does the body respond to heart failure?
Loss of cardiac output stimulates sympathetic nervous system to compensate by increasing heart rate and peripheral resistance
67
List the symptoms of heart failure
Oedema Fatigue Dyspnoea- orthopnoea and paroxysmal nocturnal dyspnoea
68
Define in terms of blood pressure cardiogenic shock
Systolic blood pressure less than 90 mmHg
69
How does cardiogenic shock progress?
Positive feedback
70
Describe the treatment for shock
Aggressive IV fluid and oxygen while monitoring airways
71
List 3 chronic heart failure treatments
ACE inhibitors Diuretics Beta blockers
72
Describe the homeostatic mechanisms for low cardiac output
Increase sympathetic activity- increase HR, increase heart contractility and vasoconstriction Kidneys accumulate fluid- Decrease glomerular filtrate rate, increase venous return and preload and increase central venous pressure
73
List the low output heart failure treatment goals
Prevent acute decompensated heart failure Counteract cardiac remodelling Minimize symptoms

Module 103: Theme 3: Physiology of the cardiovascular system. Principles of pathology, diagnosis and treatment of cardiovascular disease (19 decks)

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